Provider Demographics
NPI:1457335978
Name:TOWN OF MEDWAY
Entity Type:Organization
Organization Name:TOWN OF MEDWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-533-3209
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44 MILFORD ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-2217
Practice Address - Country:US
Practice Address - Phone:508-533-3209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3419341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
7261OtherFALLON
801447OtherTUFTS HEALTH PLAN
0020329OtherNEIGHBORHOOD HEALTH
700575OtherHARVARD PILGRIM HEALTH
MA1701118Medicaid
590011062OtherRR MEDICARE
700575OtherHARVARD PILGRIM HEALTH
MA018359Medicare ID - Type Unspecified